Feeling the pressure of insurance woes

People without insurance or who have limited insurance don’t have to feel the burden — healthcare help is out there.

Jessica Gaspar, staff writer

Walter Willson has been without insurance since he was 18. The 35-year-old is self-employed as a tattoo artist and can’t afford the insurance premiums on his own.

So, when Willson, of Brockport, gets sick or needs medical attention, he’s on his own.

“I have to pay for my own glasses, my own dental,” he said. “Pretty much everything to do with my health, I have to pay in cash for or not pay at all.”

A while ago, Willson had his wisdom teeth removed. Now, one has grown back.
“Now it’s like killing me,” he said. “They usually don’t grow back.”

But, because he doesn’t have insurance, he’s reluctant to get it pulled again, Willson said.

This week marks a nationwide effort called Cover the Uninsured Week. Its premise is to raise awareness of those without healthcare coverage.

According to John Ricci, spokesman for Monroe County’s Department of Health, Willson is not alone. About 6 percent of people in Monroe County had no health insurance in 2006, the most recent data available. That’s 37,317 people out of the 730,807 who lived here that year.

That compares to the 14 percent of New Yorkers who are uninsured, Ricci said.

“Generally speaking, we do a little bit better in Monroe County than other places,” he said.

For more information on the Charity Care discount plan through Strong Memorial Hospital, visit www.urmc.edu and search for Charity Care.

For more information on the Pfizer Helpful Answers plan, visit www.pfizerhelpfulanswers.com.

For more information on Cover the Uninsured Week, visit www.covertheuninsured.org.

Ricci could not say whether that number has risen over the past 10 years.

Throughout the week, Excellus Blue Cross/Blue Shield has been holding free screening to low-income people to see if they qualify for one of their government-sponsored health insurance plans, like Family Health Plus or Child Health Plus.

The number of patients without healthcare coverage has increased over the years, said Adam Anolick, director of finance for Strong Memorial Hospital and the University of Rochester Medical Center.

“Insurance is so expensive that if people don’t have it subsidized by their employers a lot of people just can't afford to have health insurance,” Anolick said. “A lot of employers are also cutting back on what they offer, so people are having higher co-insurances and deductibles.”

For those patients, many healthcare providers offer discounts for patients who aren’t insured or who have limited coverage, including Strong.

Whether it’s a doctor’s appointment or an emergency room visit, uninsured or underinsured patients don’t have to feel the full burden of the cost, Anolick said.

If an uninsured patient visits one of the doctor’s offices affiliated with the University of Rochester Medical Center, they qualify for a 50 percent discount on their services. Anolick said.

“That’s one thing that any of our faculty or physician offices offer to folks,” he said.
That includes orthopaedic services, primary care physician visits, among others, Anolick said.

According to Anolick, Strong also offers a charity care service, which allows uninsured and underinsured patients to qualify for a discount between 20 and 80 percent, depending on their income.

For a single person, the poverty line is $10,400, according to the U.S. Department of State.

“Anyone who comes in who has an income 200 percent of the federal poverty guideline limit will qualify for free charity care,” Anolick said.

That means, Strong will offer free services to any single person who has a yearly income of about $20,800 or less.

Strong also offers partial discounts between 20 and 80 percent to people who make up to 400 percent of the poverty level, or $41,600 per year or less.

The income levels may vary if the patient has children.

“It’s all based on tiers. The more income someone has, the lower the discount is a way to think of it,” Anolick said.

He added discounts are also offered to people who have insurance, but may have a high deductible they can’t pay.

Strong’s offerings through Charity Care have more than tripled over the last several years, Anolick said. In 2004, Strong offered $2.7 million in discounts. Last year, they offered $9.1 million in discounts.

But, Anolick isn’t sure if that’s a sign there’s more uninsured people in the Rochester area or if more people just know about the Charity Care program.

“I think the Charity Care policies are much more publicized,” he said.

Even prescription help is out there for patients who can’t afford them.

Pfizer, a pharmaceutical company, started a program called Pfizer Helpful Answers in 2004. The idea behind it is similar to Strong’s Charity Care.

“The program that we have helps people of any age or income save on Pfizer medicines or get their medicines for free,” said Gary Pelletier, director of the Pfizer Helpful Answers program.

A single patient with no children who earns $20,800 or less each year can qualify for free prescriptions, Pelletier said. Anyone who earns more than that can qualify for discounted prescriptions.

Since this program began, it has helped about 65,000 people in New York state and 5.4 million people nationally, he said.

But, programs like these are hard to qualify for, Willson said. He’s tried.

Willson earns more than twice the poverty line, but part of his income has to go back into supporting his tattoo business.

“I have to split that up into supply and rent and bills and stuff as well,” he said. “They really don't take that into account.”

Jessica Gaspar can be reached at (585) 394-0770, Ext. 323, or at jgaspar@mpnewspapers.com.

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